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THE 



MANAGEMENT OF INFANTS 



YOUNG CHILDEEN. 



GEORGE G. WOOD, M.D., 

II 

GRADUATE OF JEFFERSON MEDICAL COLLEGE, PHILADELPHIA ; 
MEMBER OF MUNCY VALLEY MEDICAL SOCIETY, ETC. 







PHILADELPHIA: 

LINDSAY & BLAKISTON. 

18 75. 






«*> 



Entered according to Act of Congress, in the year 1875, 

By LINDSAY & B L AKISTON, 

In the Office of the Librarian of Congress, at Washington, D. C. 



SHERMAN & CO., PRINTERS. 



CONTENTS. 



Preface, . 

Introduction-, . 

The Newborn Infant, 

Dressing, . 

Food, 

Sleep, 

Constipation, 

Weaning, 

Clothing, 

Bathing, . 

Exercise, . 

Walking, 

Ventilation, 

Government, 

Conclusion, 



PAGE 

5 
7 

11 
13 
15 
20 
22 
24 
30 
37 
39 
42 
43 
46 
48 



PREFACE. 



In presenting my readers with this little 
work, it has been my endeavor to condense 
into the smallest space all the requisite and 
most necessary information relative to the 
management of infants and young children. 
The widespread ignorance and the almost 
criminal neglect which many of our young 
children are exposed to, must be due to a 
want of knowledge on the part of their 
parents. 

Hence the introduction of this little book, 
which is intended to be within the compre- 
hension of all those to whom the manage- 
ment of young children is intrusted. 

G. G. W. 

December 1st, 1875. 

( * ) 



INTRODUCTION. 



First, I shall devote a few words in behalf 
of the subject I am about to discuss, the im- 
portance of which some are slow to admit, 
but the many have commenced to realize. 

The first requisite for success in life is a 
thorough knowledge of the occupation to be 
pursued. When the gardener assumes man- 
agement over his garden, can he expect suc- 
cess unless he full}" understand the nature 
and properties of the plants he cultivates ; 
need he expect success if he is ignorant of 
the time to sow his seed, and when to trans- 
plant ? 

And so it is with the 3 T oung mother, and 
the inexperienced nurse. The Creator places 

( 7 ) 



o INTRODUCTION. 

in their arms a tender plant to be nurtured 
and cared for; no garden plant or flower is so 
tender or so delicate — none requires so much 
gentleness, so much dexterity in the hand- 
ling, and j^et whilst we seek knowledge 
in taking care of our gardens we are too 
ready to place this precious plant, the infant, 
in the hands of ignorance and quackery. 
Dr. Getchell says : " Statistics go to prove 
that nearly one-half of the children born, die 
before they are five years of age, and that 
more than one-fourth die before they can lisp 
their mother's name." 

We ask, wiry is this so — can it be traced to 
any other cause than improper management? 
true, diseases kill them, but what are the 
causes of disease ? Is there not always some 
predisposing cause for disease to lay hold on ? 

Health is only loaned to us, so long as we 
take care of it. Nature teaches us how to 
observe laws for its preservation, and just as 
soon as we depart from those laws, health is 
withdrawn, and disease, the direct enemy of 
health, lays waste our bodies. 



INTRODUCTION. V 

So it is with rearing infants ; we too often 
resort to art, when nature should be the only 
guide, and as nature is departed from disease 
comes in to claim the prize. A few rules for 
employing a physician, and I shall enter on 
my subject proper. Employ a physician in 
whom you have confidence, and then trust to 
him implicitly. Send for him as soon as dis- 
ease makes its appearance, and follow his di- 
rections closely. 

Do not change your physician unless for 
very good reasons. The knowledge he gains 
of the peculiarities of members of your 
family is too precious to be sacrificed for a 
whim. 

Do not change his directions without his 
leave or knowledge. 

Do not add or omit treatment on your own 
responsibility unless there is a great emer- 
gency. 

Finally, co-operate with him in all that he 
does. 




Hattagement 0fj ittfattfe* 



The Newborn Infant. 

The child when handed over to the nurse 
should be washed and dressed as soon as 
possible ; to do this with dispatch everything 
wanted should be prepared beforehand, so 
that no delay is necessary. 

The infant should be carried rolled in soft 
flannel to the fire, where the washing should 
take place. Infants are usually covered with 
a white cheesy coating (vernix caseosa). 
This coating is due to a secretion from the 
sebaceous follicles, a perfectly natural condi- 
tion for the skin of the newborn infant, but 
unfortunately this coating is sometimes diffi- 
cult to remove. The nurse should seat her- 
self near the fire, with the infant on her lap ; 

( n ) 



12 MANAGEMENT OF INFANTS. 

she should be provided with a sponge, cas- 
tile soap, sweet oil, soft towels,, and an 
abundance of warm water. The child should 
be first well oiled all over its body, followed 
by the soap and warm water. There will be 
no difficult} 7 in removing this coating by this 
method. Clean unsalted lard may be used 
as a substitute for the sweet oil; great care 
should be used in cleansing the flexures of 
the joints and ears. The e} 7 es and face 
should not be washed till last, and then only 
with pure water and a clean cloth, not the 
cloth and water used for washing the bod} 7 , 
bear in mind. Also the nurse should re- 
member that the skin of the infant is ex- 
ceedingly delicate, and will not bear hard 
usage, without great danger of tearing the 
cuticle, and thus subjecting it to great dis- 
comfort. 

The washing completed its skin should be 
dried by means of a soft towel or soft warm 
flannel; not by rubbing, remember, as is the 
habit of some nurses. This done, and the 
infant is ready to be dressed. 



MANAGEMENT OF INFANTS. 13 



Dressing the Newborn Infant. 

The first article of dress should be a 
binder of soft flannel, about six inches wide 
with no hem on its edges, and long enough 
to go twice around the body of the infant. 
This should be comfortably fastened either 
with tape or pins, care being taken that the 
binder is not applied too tight, lest it do more 
harm than good by interfering with its breath- 
ing. Many infants are compelled to do all 
their breathing with their chests in conse- 
quence of a too tight bandage around their 
abdomen. This is entirely against nature, 
for if notice is taken the breathing will be 
found to be carried on almost entirely by the 
rising and sinking of the abdomen or belly, 
and not so much by the chest, as in after- 
life. 

The remainder of the clothing should be 
light, soft, and warm, and so made that it 
can be easily put on or taken off. Dr. 
Churchill in his work on Diseases of Children 
lays down for mothers the following in re- 



14 MANAGEMENT OF INFANTS. 

gard to dressing their infants: " The infant 
requires softness, looseness, and . warmth, 
and as regard to handling, gentleness and 
dexterity." 

The feet and legs to the knees should be 
covered with soft woollen socks or stockings ; 
the head should be left bare, on account of 
the great tendency to nervous excitement, 
and rapid circulation in early life. In win- 
ter especially the infant's neck and arms 
should be well protected. I am inclined to 
urge this matter as also being advisable in 
summer ; it stands to reason, that it is at 
least dangerous ; and what sense is there in 
endangering the life of a child for the sake 
of displaying its bare neck and arms to an 
admiring multitude ? A writer truly says, 
in speaking of clothing children : " Had we 
a little more common sense, more sleeves 
and sacks, and high dresses, and less vanity 
and fashion, mothers would have fewer little 
graves to weep over." In summer the child 
should not be dressed too warmly, but cool 
enough to be at least comfortable. It is 



MANAGEMENT OF INFANTS. 15 

mainly clue to the excessive heat of summer 
that so many children die during that season. 
Thousands are carried away every summer 
in our cities from diseases consequent on 
excessive heat ; keep your infants therefore 
warm in winter, and cool in summer. 

As soon as the infant is dressed and the 
mother made comfortable, it should be placed 
at the breast, as it will be more likely to take 
the nipple then, than if you wait for several 
hours to intervene. 

Food for Newborn Infants. 
The subject of proper food for the newly 
born infant is full of interest, and has been 
investigated by learned physicians to the 
uttermost ; yet there is no subject which the 
plrysician is more liable to err in, or which 
he is in more danger of being overruled b} 7 
nurses or mothers. The general impression 
is that the infant is born into the world in a 
state of starvation, and that its first cries are 
for food, whereas, it has just concluded a 
full meal, and its plump appearance would 



16 MANAGEMENT OF INFANTS. 

indicate that its food had agreed with it^to 
perfection, and had not come from a land of 
starvation, as the anxiety of the nurse to 
feed it would lead us to suppose. 

The newborn infant as soon as born com- 
mences to lead a new existence ; its organs 
must support it alone now ; not only must it 
breathe for itself, but it must eat and di- 
gest its own food. But nature has not yet 
prepared its digestive organs for the recep- 
tion of food. There is a peculiar secretion 
from a healthy woman's breast, which is 
called colostrum ; this is present in the milk 
for two or three days, and then disappears. 
This colostrum acts in two ways, first as a 
nourishment, and second as a purgative. 
Placing the infant at the breast as soon as 
dressed as already directed, it feeds upon 
this material, which cleanses the bowels of 
that dark-green matter first passed by the 
infant called meconium. After waiting, and 
this colostrum does not act in the way that 
nature has intended, then, and not until 
then, is it advisable to employ some artificial 



MANAGEMENT OF INFANTS. 17 

means to that end, and fresh castor oil is the 
only safe physic, given in half teaspoonful 
doses, repeated if necessaiy in six hours. If 
this has not the desired effect a physician 
should be consulted at once. 

Generally then the infant should be given 
the breast within three or four hours after 
birth, provided the mother has done well. 
If she has no milk by that time she soon 
will have. Let the infant depend upon its 
mother for nourishment, unless there is good 
reason to believe that it cannot be raised in 
that way, as is often the case. But the mo- 
ther being healthy, on no account resort to 
artificial food ; do not give it sugar and 
water, or flour and water, or catnip-tea, or 
anything, unless 3011 want to have it afflicted 
with colic. The closer we imitate nature in 
all these matters the better. 

Should it be found necessary to provide 
food for the infant on account of the various 
causes that ma} 7 arise, we will find that the 
best substitute for mother's milk is goat's or 
good cow's milk. The cow should be fresh 
or nearly so, and the milk unskimmed ; it is 
2 



18 MANAGEMENT OE INFANTS. 

known to farmers as new milk. Two parts 
of this new milk, and one part, of water, 
with a little sugar added, makes it very much 
like human milk. It should be about the 
same temperature as the body, ninety-five or 
ninety-eight degrees F. The infant should 
not be allowed to nurse oftener than once 
every two or three hours. 

If a wet-nurse is employed, the following 
rules should be observed in selecting one. 
She should be perfectly healthy ; have no 
constitutional taint; have plenty of milk. 
She should be temperate in her habits of 
eating and drinking, and her babe should be 
of the same age as the one she takes to 
nurse. 

If the nursing-bottle is used, one with a 
large gum nipple to fit over the mouth of the 
bottle is far preferable to those with gum- 
tubes, on account of the latter being so hard 
to keep clean ; in fact it is impossible to 
keep them as clean as they should be. With 
the former all that is necessary to cleanse 
them perfectly is to turn them inside out. 

To recapitulate what I have said in regard 



MANAGEMENT OF INFANTS. 19 

to feeding infants, first let me urge upon 
mothers, when practicable, to nurse their own 
children. Do not trust them to wet-nurses 
unless necessary. Do not put them upon 
the mercies of a nursing-bottle unless you 
have to, and what is still more imperative, do 
not let them starve trying to live upon the 
many artificial preparations said to be sub- 
stitutes for milk. In newborn infants milk 
of some kind is the only food suitable for their 
powers of assimilation ; when nature provides 
teeth for the infant, then it will be soon 
enough to feed it upon farinaceous articles of 
diet. Nothing will more quickly derange an 
infant's digestive organs, nothing will more 
quickly predispose it to attacks of dj T senteiy, 
diarrhoea, cholera infantum, and other sum- 
mer diseases, which fill our churchyards and 
cemeteries with so many little graves, than 
using patent infant food, which our chemists 
delight to prepare as the result of theory 
but not of practice ; they might just as well 
prepare that vital fluid which we call blood 
because they know its analysis, and after in- 



20 MANAGEMENT 0E INFANTS. 

jecting it into our veins, expect it to sus1>am 
life, and call it a substitute for blood. 

Sleep. 

An infant must have plenty of s^ep. It 
can sleep three-fourths of its time without 
injury. Great regularhYv should be observed 
in putting it to sleep. It should not be 
held in the nurse's arms whilst sleeping, 
but should be laid down, and warmly cov- 
ered. In commencing thus early there will 
be no difficulty experienced, but if no rules 
are observed bad habits will be formed 
which are hard to get rid of. The habit of 
sleeping is very much like the habit of eat- 
ing. At the hour we are in the habit of 
dining, our appetites will call for food ; at 
the usual time of our going to bed we will 
experience a desire for sleep ; so will it be 
with the infant if the right commencement is 
made. If we commence with irregularity it 
will always be irregular in its habits. Let 
the child awake itself. You can starve it for 
want of sleep as well as for want of food. 



MANAGEMENT OF INFANTS. 21 

Light and noise should be carefully excluded 
from a room where an infant is reposing. It 
is wrong to suppose that noise is not injuri- 
ous as long as the child is not awakened. 
The first few months, especially in winter, 
the infant should sleep at night with its mo- 
ther, on account of its feeble powers of gen- 
erating animal heat. In summer after the 
first few weeks it does not make so much 
difference ; after that the child should be 
transferred to a crib, standing close to the 
bed of the mother 'or nurse, and if its desire 
to return to the bed be discouraged for a 
few nights there will be no further trouble. 
The bed should be properly aired, and also 
it should stand in the sunshine for a couple 
of hours each day. 

If care and management are used little so- 
licitation will be necessary to put infants to 
sleep. The desire for repose will occur at 
regular intervals, and if this regularity is 
persisted in there will be no necessity in em- 
ploying any artificial means, for they will 
drop to sleep themselves when the hour ar- 



22 MANAGEMENT OF INFANTS. 

rives. For no reason whatever administer 
any narcotics unless on the advice 'of a phy- 
sician. If the child is restless and sleepless, 
there are other causes at work than want of 
sleep. If laudanum, paregoric, or some 
"soothing syrup," so-called, which is only 
another name for an opiate, is used to pro- 
duce sleep, it is at best an artificial sleep, 
and is productive of no good ; on the contrary 
it is productive of much harm, for it will re- 
quire a larger dose the next day to produce 
the same effect ; the appetite is destroyed, 
digestion interfered with, the child becomes 
puny, and sinks under the first malady with 
which it may be attacked. It is startling 
when we consider how common it is for mo- 
thers and nurses to administer opiates in the 
shape of cordials, anodynes, and soothing 
syrups to produce sleep and quiet in their 
children ; and yet we pretend to not know 
why there is such great mortality among in- 
fants and children. Shame! 

Constipation. 
Many children are troubled from birth 



MANAGEMENT OF INFANTS. 23 

with constipation or costiveness of the 
bowels. It is a mistake for parents to be 
continually giving laxatives and purgatives, 
for according to a certain law well known 
to physicians, the more cathartics you use 
the more you ma}' ; besides, all purgatives 
given by the mouth have a tendency, when 
often repeated, to break down the digestion. 
A little wedge of castile soap placed in the 
rectum of the infant, or an injection of tepid 
water, given at precisely the same hour in 
the da} T , so as to produce an evacuation once 
in twentjvfour hours, is usually sufficient to 
remove the trouble. If this does not pro- 
duce the desired effect a physician should be 
consulted. Colic is often caused by consti- 
pation, or at least aggravated by it. It may 
be also due to the formation of gas in its 
little intestines. In many instances it may 
be relieved by the application of a hot flannel 
cloth over its abdomen, or the administration 
of peppermint or fennel-water. Pressing 
gently its little stomach with the hand often 
relieves it for a time. 



24 MANAGEMENT OF INFANTS. 



Weaning. 

Weaning should be effected in from nine 
to fourteen months, or as soon as the teeth 
show sufficient development to masticate the 
food ; this usually occurs at fifteen months 
at the latest. It should be done gradually, 
that is, artificial food should replace the milk 
more and more frequently until the breast is 
only given at night, and at last not given at 
all. It is not well to wean a child when it is 
ailing ; a favorable opportunity must , be 
sought. Neither should it be weaned during 
the hot summer months. The best months 
in the year are April, May, September, and 
October. There is no objection to the winter 
months. Exercise in the open air is of the 
greatest importance to the child at this time ; 
nothing tends more to soothe the nervous 
irritability so often cou sequent on this 
change. It exerts a decided influence on 
the general health, gives tone to the diges- 
tive organs, and enables them the better to 
bear the change of nutriment. The food as 



MANAGEMENT OF INFANTS. 25 

a rule that best agrees with the child should 
be used and adhered to. The crumb of 
bread boiled in milk, and sweetened a little, 
is a good food. Another is, mix two parts of 
wheat flour with one part of oat-meal well 
baked ; take two tablespoonfuls, with half a 
pint of milk, and this well boiled and sweet- 
ened, is a capital food for a weaning child. The 
change from milk diet to that of solid food 
should be very gradual. For some time after 
the child is weaned it should subsist on liquid 
substances, such as gruel, pulverized cracker 
dissolved in milk, and the different prepara- 
tions of arrowroot ; these and other articles 
of like nature should constitute the entire 
diet for several months after weaning. Xo 
difficulty need be experienced in changing 
from fluid to solid food if the stomach be- 
come accustomed to it gradually, but if the 
change is made abruptly, indigestion will be 
the result. 

Until the child is past two } T ears of age it 
will require very little solid food. The child 
should eat slowly, and be fed at regular in- 



26 MANAGEMENT OF INFANTS. 

tervals, eat slowly, that its food may^be 
thoroughly masticated and mixed with the 
saliva of the mouth before swallowing, for 
this is the first act of digestion. It should 
eat slowty, because if it eats fast it will eat 
too much, and thus paralyze the stomach 
from overdistension How much more injuri- 
ous must be this habit on the child with its 
delicate frame and organs than on the adult, 
and we all know the influence of bolting 
food at the rate of sixty miles an hour on 
the latter. 

By feeding it at regular intervals, I mean 
not to be feeding it continuously, as is the 
habit of some mothers ; neither do I mean 
that it must eat only three meals a day, for 
the growing child requires more food com- 
paratively than the adult ; but what I do 
mean is to divide its waking hours equally 
into four meals ; its last meal, which should 
be taken a short time before going to bed, 
should be food of the blandest and most di- 
gestive character. Children should not have 
too great a variet}', for as a rule those chil- 



MANAGEMENT OF INFANTS. 27 

dren that subsist upon a few of the more di- 
gestible kinds of food are much healthier 
than those allowed a great variety. 

Vegetables should enter sparingly into the 
nutriment of the young child, and once a 
day a reasonable quantity of animal food, 
well prepared, will be found to agree with it. 
Beef, mutton, fowl, and fresh fish are the 
most suitable ; veal, pork, and all kinds of 
preserved meats should be avoided. Ripe 
fruits are very good for children when taken 
in moderation, but the seeds and skins 
should be removed, lest they excite irritation 
in the bowels and stomach. The following 
bill of fare for children older than those I 
have spoken of will serve as a guide to those 
parents who believe, like m} T self, in systema- 
tizing the management of children. 

For Breakfast. 

Half pint of hot new milk poured on a 
slice of bread ; a little sugar may be added 
to it if the child prefers, or bread and butter 
and chocolate, mixed with plenty of milk. 



28 MANAGEMENT OF INFANTS. 

Chocolate is very nutritious, and children 
learn to like it. 

For Dinner. 

Beef tea, chicken-broth, or mutton-broth, 
with crackers broken in, flavored with pepper 
and salt, makes an excellent soup. Rice, 
custard, sago, tapioca, corn-flour, and light 
puddings generally may be set before the 
child. Fresh fish, boiled rather than fried, 
roast mutton, roast beef, chicken, pigeon, 
rabbit, turkey, and fresh meats used spar- 
ingly. Yegetables as a rule are hard to di- 
gest in the child's stomach, and should be 
employed carefully. Milk or water as a bev- 
erage, and ripe fruits. 

For Supper. 

Gruel, rice pudding, corn-starch, arrow- 
root, with bread and butter, and weak tea. 

As a child should eat more frequently 
than the adult, it is advisable to give them a 
lunch at some regular time, which may be 
made up from the above list. Four. meals are 



MANAGEMENT OF INFANTS. 29 

all that they require in a day, and in observ- 
ing perfect regularity with them, there will 
be no difficulty in keeping the child from 
eating more frequently, which is so injurious. 
The following recipes are intended for spe- 
cial forms of diet ; the} 7 have been highly 
recommended by the Obstetrical Society of 
Philadelphia, and I think are worthy of trial. 

Boiled Flour, or Flour Ball. 

Take one quart of good flour, tie it up in 
a pudding-bag so tightly as to get a firm 
solid mass ; put it into a pot of boiling water 
early in the morning, and let it boil until 
bedtime; then take it out and let it dry. 
In the morning peel off from the surface and 
throw away the thin rind of dough, and with 
a nutmeg grater grate down the hard dry 
mass into powder. Of this from one to three 
teaspoonfuls may be used, by first rubbing 
it into a paste with a little milk ; then adding 
to it about a pint of milk, and finally by 
bringing the whole to just the boiling-point ; 
it must be given through a nursing-bottle. 



30 MANAGEMENT OF INFANTS. 

An excellent food for children who^are 
costive in their bowels, may be made by 
using bran meal or unbolted flour, instead of 
the white flour, preparing it as above directed. 

Rice-water. 

Wash four tablespoonfuls of rice ; put it 
into two quarts of water, which boil down to 
one quart, and then add sugar and a little 
nutmeg : this makes a pleasant drink. A half 
pint or a pint of milk added to this just be- 
fore taking it from the fire, and allowed to 
come to a boil, gives a nourishing food suit- 
able for cases of diarrhoea. Sago, tapioca, 
barley, or cracked corn can be prepared in 
the same manner. 

Beef Tea. 

Take one pound of juicy, lean beef, say a 
piece of the shoulder or round, and mince it 
up with a sharp knife on a board or mincing- 
block; then put it with its juice into an 
earthen vessel containing a pint of tepid 
water, and let it stand for two hours. Strain 



MANAGEMENT OF INFANTS. 31 

off the liquid through a clean cloth, squeezing 
well the meat, and add a little salt. Place 
the whole of the juice thus obtained over the 
fire, but remove it as soon as it has become 
browned ; never let it boil, otherwise most 
of the nutritious matter of the beef will be 
thrown down as a sediment. Prepared in this 
way the whole nourishment of the beef is re- 
tained in the tea, making a pleasant and 
palatable food ; a little pepper or allspice may 
be added if preferred. Mutton tea may be 
prepared in the same way; it makes an 
agreeable change when the patient has be- 
come tired of beef tea. 

Raw Beef for Children. 

Take half a pound of juicy beef, free from 
any fat ; mince it up very finely ; then rub it 
up into a smooth pulp, either in a mortar or 
with the ordinary potato-masher. Spread it 
out upon a plate, and sprinkle over it some 
salt or some sugar if the child prefers it. 
Give it with a teaspoon, or upon a buttered 
slice of stale bread ; it makes an excellent 
food for children with dysentery. 



32 MANAGEMENT OF INFANTS. 



Clothing. 

I have already spoken of the manner of 
dressing infants, and the rules that should 
govern mothers and nurses in that respect. 
Now I shall discuss the subject of dressing 
children. What sense is there for mothers 
to so dress their children that their necks, 
arms, and legs shall be bare, when they are 
told almost daily by their physician, that 
such a course will be sure almost to deprive 
it of health, yea, even of life. But mothers 
will say, if I dress it differently it will Lok 
horrid, and what is still worse unfashionable. 
Fashion is good in its place, but when it 
comes in to destroy or at least counteract 
the wisdom and common sense of our chil- 
dren's mothers, then I say it should be ban- 
ished from society and the land ; to put it 
still more strongly, it is simply infanticide 
and nothing else, for mothers to persist in 
such a course. 

Lung diseases are much more common 
and fatal in childhood than in adult life be- 



MANAGEMENT OF INFANTS. 33 

cause of greater susceptibility to atmospheric 
changes. Children are less able to resist 
such diseases as pneumonia, croup, bronch- 
itis, coryza, and catarrh. 

As we have already seen that the treat- 
ment of the digestive organs during infancy 
gives them their character for life, so does 
the treatment of the respiratoiy organs dur- 
ing infancy determine with the same cer- 
tainty whether there shall be a predisposi- 
tion to pulmonary disease thereafter. These 
facts have a great deal of significance when 
we connect them with the alarming preva- 
lence of consumption among our j'oung. 
Alas, how many of the most promising .young 
men, how many of the brightest and fairest 
young women who are laid in premature 
graves, owe the seeds of their dread disease 
to improper management in childhood. It 
is well as parents to ask ourselves this ques- 
tion, and, if possible, help stem the current 
which is carrying the world's best jewels to 
the sea of eternity. 

Many mothers will say the}^ desire to 
harden the constitution of their child, so 
3 



34 MANAGEMENT OF INFANTS. 

that it will not take cold so easily, and for 
that purpose they wish to commence early, 
the earlier the better; and they will draw 
your attention, by way of an argument, to 
the life of exposure which the Indians lead, 
and how healthy and hardy they are ; she 
thinks she has convinced you, until you ex- 
plain to her, that few Indian children live to 
adult life; that the exposure and hard life 
they lead kill the majority of their children; 
and that it is onlv the few who are strong 
enough to go through it. Thus of necessity 
almost the adult Indian is strong and healthy. 
If the same circumstances surrounded our 
lives also, there would be none but strong 
men and women survive. No ; in civilized life 
childhood is not the time to harden constitu- 
tions ; if harden you must, wait until their 
bodies have obtained sufficient stamina to 
withstand shock, and the hardening process 
you propose. 

Dr. Charles D. Meigs says, in relation to 
this subject : " I have invariably for a long 
series of years combated, as far as in me lay, 



MANAGEMENT OF INFANTS. 35 

this vicious custom. I have found a few 
sensible mothers who would listen to my in- 
junctions, but I have found a vast number of 
children to suffer, and a multitude to perish, 
from the disregard to the dictates of common 
sense; one pretext for this imprudent ex- 
posure of the infant is that it should be early 
hardened ; but I submit to the intelligent 
mother, the question whether the surest way 
to harden the child is not that way which 
will conduct it through the first six years of 
its existence?" 

Dr. Condie says : " To leave the neck, 
shoulders, and arms nearly or quite bare, 
however warmly the rest of the body may be 
clad, is a sure means of endangering comfort 
and health, and it is not impossible that the 
foundation of pulmonaiy consumption is laid 
during childhood. It is an important pre- 
caution therefore to have the dress worn by 
children so constructed as to protect the 
neck, breast, and shoulders, and with sleeves 
long enough to reach to the wrists." The 
mother's motto should be, plenty of air inside 



36 MANAGEMENT OF INEANTS. 

of the chest, but warmth outside, for trreir in- 
fants. In clothing children we should en- 
deavor to preserve the natural temperature 
of the skin ; to do this, " soft flannel should 
be worn next the skin the year round ; in 
summer it should be of the lightest variety." 
Flannel has a great many advantages over 
cotton or linen, the main one is that it is a 
very poor conductor of heat, thus retaining 
nearly all the animal warmth. 

The clothing should be loose, light, and 
simple, so that it may easily be put on or 
taken off without great annoyance to the 
child. The legs in winter should be covered 
with worsted stockings which extend above 
the knees. Until the child walks it should 
wear socks ; after that it should be provided 
with shoes of soft leather. No caps or cov- 
ering should be allowed whilst in the house, 
because of its tendency to accelerate the cir- 
culation in the head. The frock should have 
long sleeves, and be high in the neck. It 
should be very light and simple in its con- 
struction, should be heavier in winter than 



MANAGEMENT OF INFANTS. 37 

in summer. Do not load the poor infant 
down with all the ruffles and flounces which 
your fashion-book tells you, but have it made 
plain and comfortable. Too much clothing 
is of course to be avoided, since by accumu- 
lating warmth and relaxing the vessels of 
the skin debility is produced. 

Our atmospheric changes are so sudden 
and great that mothers have to be constantly 
on the alert. Our clothing is the greatest 
protection we have against such vicissitudes, 
and the best rule that may be followed by 
all, both parents and children is, u dress ac- 
cording to the weather." 

Bathing. 

The health of a child will depend very 
much on its being kept clean. It is one of the 
first laws of nature, and therefore should be 
strictly observed. Children that have been 
taught from experience the necessity of fre- 
quent ablutions will keep up the habit in 
after-life much to their benefit. 

The young infant should be bathed in pure 



38 MANAGEMENT OP INFANTS. 

soft tepid water at least once a day; 4he 
water should be about the temperature of the 
blood. It is better to use a thermometer 
than depend on telling the temperature by 
the nurse's hand, which is far from certain. 
The elbow is a much better guide than the 
hand. The water should not be too warm 
or too cold : if too warm, it will have a debili- 
tating influence ; if too cold, it will drive all 
the blood from the surface to the internal 
organs. 

The bath should be given in the morning 
two hours at least after a meal. 

All but the head should be immersed ; 
many mothers immerse only the lower part 
of the body, which is very wrong, as the 
upper part is likely to become chilled, and 
thus give rise to catarrh and bronchitis. It 
may be allowed to remain in the bath from 
three to five minutes ; as it grows older the 
time ma}^ be extended. After being taken out 
it should be wiped dry with a soft flannel 
cloth, followed by a brisk gentle friction for 
a few minutes, care being taken that the skin 



MANAGEMENT OF INFANTS. 39 

is not injured, for an infant's skin is quite 
tender and delicate. Soap should not be 
used at all for young infants ; for older ones 
the white castile is much to be preferred, as 
it is made with a vegetable oil instead of an 
animal oil. In winter-time a bath every 
other day will be sufficient. Where the nurse 
washes the infant in her lap, the greatest care 
should be taken that it does not not take 
cold. One portion of its body should be 
washed, dried, and the clothing put on, before 
the other part is uncovered. 

Everything pertaining to the cleanliness 
of the child should be strictly attended to ; 
soiled linen or portions of dress should be 
removed as soon as possible. 

Exercise. 

Exercise may be divided into indoor and 
outdoor; indoor exercise is very important, 
just as important in its way as the outdoor. 

For the first few months, the exercise of 
the infant should be passive; extreme care 
should be taken that its motions are not 



40 MANAGEMENT OF INFANTS. 

made abruptly, or with violence ; too much 
gentleness cannot be used in handling a young 
infant. When carried it should be in the re- 
clining position, with its little head supported. 
In fact the reclining posture is the only posi- 
tion for the infant until it is four or five 
months old; before that the upright position 
is dangerous for the future welfare of the 
child, because the spinal column is too weak 
to support the weight of the head and 
shoulders ; spinal curvature or humpback is 
frequently the result if this matter is lost 
sight of. 

In lifting them we should place our hands 
on each side of the chest below the armpits, 
and under no consideration catch hold of 
their arms for that purpose, as the arms may 
easily be wrenched or pulled out of their 
sockets, or the collar-bone distorted and 
fractured. 

In lifting the infant from the cradle or bed 
the head should always be supported; all 
rough usage, romping, tossing it into the air 
to catch again, is always dangerous. 



MANAGEMENT OF INFANTS. 41 

A good way for a child to exercise, at the 
same time give temporary rest to the mother, 
is to place the infant on the floor, on a pillow 
or small mattress, lying on its back; this 
allows it a chance to throw and kick its 
limbs around at will with no danger of fall- 
ing. During summer, in pleasant weather, 
after it is three weeks old, it ma} T be taken 
out for an airing almost daily; protecting it 
well from all the changes of temperature, and 
covering its face with a green veil to protect 
its eyes from too strong a light. When the 
child has acquired sufficient strength for 
more active exercise, a playground should 
be provided for it in nice weather, and a play- 
room for bad weather; it should have an 
abundance of toys and games, so that when 
tired of one another can be quickly substi- 
tuted. 

By this method all the muscles in its body 
will be called into activit} 7 , and health, vigor, 
and growth will be the result; its disposition 
will not become peevish and fretful near so 
readily as where these measures are neg- 
lected. 



42 MANAGEMENT OF INFANTS. 

The trouble and expense of providing 
ample means of amusement for children will 
be more than repaid, by the good health and 
cheerful dispositions which will surely be de- 
veloped if this principle is followed. 

Walking. 

Before the child will be strong enough to 
walk it will make efforts to creep; these at- 
tempts should be discouraged as much as 
possible, because the act of creeping calls 
into play but half the muscles of its body ; 
these muscles will become strengthened at 
the expense of the rest, and the symmetry 
of its form will be lost. Again, creeping is 
objectionable on account of its soiling its 
clothes so much that it will be almost impos- 
sible to keep it clean. 

The efforts of a child to walk should never 
be stimulated or encouraged by parents ; it 
will be time enough for them to walk when 
their limbs are strong enough to support the 
weight of their bodies. In childhood, it 
should be remembered, that the bones are 



MANAGEMENT OF INFANTS. 43 

far from hard ; that they are soft arid pliable, 
will bend very easity; therefore, if a child 
walks too soon its legs will bend under the 
weight, and remain so, making what is popu- 
larky known as a bow-legged child, which de- 
formity will remain in spite of surgical in- 
terference. All contrivances invented for the 
purpose of teaching a -child to walk should 
be burned. As I have already said, when 
the proper time arrives for the child to walk 
it will not need assistance. 

There is a disease called rickets which 
scrofulous children are liable to ; the bones 
remain soft for a long while, the legs be- 
come bowed, and grow so if allowed to walk; 
this should be guarded against by applying 
supports, and if used in time will prevent it. 

Ventilation. 

TVe all know the importance of having 
pure good air to breathe. There has been 
so much attention paid to this subject of late, 
both in books and on the forum, that the 
public should be as well informed on it as 



44 MANAGEMENT OF INFANTS. 

they are upon the latest novel, so I shall 
say but little ; will endeavor only to impress 
its importance more fully upon the minds of 
parents in reference to the management of 
children. The child can live for a few days 
without food, but it cannot live at all without 
air. Vitiated air in rooms where children 
are kept cannot but be a fruitful source of 
disease to them. 

At no time in life are the effects of impure 
air more injurious than during childhood, 
for childhood is the seed-time of life. What- 
ever is sown then will be reaped fourfold. 
It is not so much the rooms in which the 
child is kept during the day that demand at- 
tention as it is their sleeping apartments. 
The former are usually well ventilated by 
the running in and out at the door, but the 
latter have no such advantages. The child 
is often compelled to breathe the air again 
and again at night whilst sleeping; it thus 
becomes loaded with impurities. Children's 
sleeping-rooms can best be ventilated b3 r 
opening the window for a few inches from 



MANAGEMENT OF INFANTS. 45 

the top ; the blind will prevent any draft 
from being carried to the child, and if the 
weather is cold, a little more fuel or clothing 
will keep it from catching cold. Another 
means of ventilation is leaving the door 
open into another room which is ventilated 
property. With such ventilation there is no 
danger of the child taking cold ; of course 
the child must have sufficient bed-clothing 
to keep it warm. 

With attention to ventilation the air in a 
room heated with a stove can be kept pure 
enough. The best kind of a fire, however, 
for a sleeping-room is that with an open fire- 
place. 

In concluding this subject I would draw 
} T our attention to what Dr. Hartshorne says 
on it : "Every zjmiotic disease is rendered 
more fatal, if not more prevalent, by foul 
air. Any sanitarian might designate in a 
city what wards, blocks, courts, alle3 T s, and 
houses will always afford the largest number 
of deaths from scarlet fever, measles, and 
cholera infantum. The great importance of 



46 MANAGEMENT OF INFANTS. 

the impurity of the atmosphere as a factor 
in the mortality of infants has been fully 
recognized in times past." 

Government. 

Dr. Gretchell says: "During the first few 
years of life it is by authority alone that the 
child should be governed. The parent's 
word should be the child's law, and never 
should be questioned. At this tender age 
the child is incapable of reasoning, and in- 
stead of taking the long and circuitous path 
of an argument, much happiness will be 
gained and many tears prevented, if we ar- 
rive at the same point by the simple princi- 
ple of you must and you can't." 

We should never bribe the child to obey, 
neither should we frighten it. If the infant 
is taught from the first to do as told it will 
fall into a habit of cheerfully obeying. 

Parents should be gentle and considerate 
in their commands, but firm as a rock. 

If we would have our children grow up 
gentle and true we must continually exhibit 



MANAGEMENT OF INFANTS. 47 

these qualities to them, for they are the 
greatest imitators in the world. 

Dr. Combe says: "If we cannot restrain 
our own passions, but at one time overwhelm 
the young with kindness and at another con- 
found them by caprice or deceit, we may as 
well expect to gather grapes of thorns or figs 
of thistles, as to develop moral purity and 
simpleness of character in the child." 

Harshness is never necessary for the gov- 
ernment of children. By kindness and firm- 
ness we shall be able to do all that is re- 
quired with them. 

When the proper time comes instruction 
from books is required, but the child's body 
should have time to develop itself before we 
undertake to cultivate its mind. By thus 
waiting much advantage will be gained, the 
child will be more able to accomplish its 
tasks without danger of ruining its body 
and mind, as is too often the result when 
they are put at their books at so tender an 
age. 

It matters very little whether the child can 



48 MANAGEMENT OF INFANTS. 

read and write at ten years. But it k of 
considerable consequence if by cramming the 
brain its health is destined. 

Dr. Caldwell says : " From an unwise at- 
tempt to convert their flowery spring into a 
luxuriant summer, that summer too often 
never arrives, the blossom withers ere the 
fruit is formed." 

Whilst children can be sent to school too 
soon, so can their minds be too much neg- 
lected ; like every subject it has two ex- 
tremes, and it is for us to choose midway 
between, that we make no error. 

A child's questions should always be 
answered in good faith ; they should not be 
told, you cannot understand it. Remember, 
when they ask a question, that it is their 
only way of gaining information. Therefore 
do not bluff them off, or seek to fill their 
little brains with nonsense. 

Conclusion. 

In concluding this little volume I shall ap- 
pend a report of a committee appointed by 



MANAGEMENT OF INFANTS. 49 

the Obstetrical Society of Philadelphia, " to 
consider the causes and prevention of infant 
mortalit} 7 during the summer months." 

These rules are so full of good instruction 
that I cannot resist the temptation to pre-' 
sent them to m} T readers entire ; they are as 
follows : 

Rule I. 

Bathe the child once a day in tepid water. 
If it is feeble, sponge it all over twice a day 
with tepid water, or with tepid water and 
vinegar. The health of the child depends 
much upon its cleanliness. 

Rule II. 

Avoid all tight bandaging ; make the 
clothing light and cool, and so loose that the 
child may have free play for its limbs. At 
night undress it, sponge it, and put on a slip. 
In the morning remove the slip, and dress 
the child in clean clothes. If this cannot be 
afforded, thoroughly air the day clothing by 



50 MANAGEMENT OF INFANTS. 

hanging it up during the night. Use clean 
diapers, and change them often. Never dry 
a soiled one in the nursery or in the sitting- 
room, and never use one the second time 
without first washing it. 

* EULE III. 

The child should sleep by itself in a cot 
or cradle. It should be put to bed at regular 
hours, and be early taught to go asleep with- 
out being nursed in the arms. Without the 
advice of a physician never give it any 
spirits, cordials, carminatives, soothing syr- 
ups, or sleeping drops. Thousands of chil- 
dren die every year from, the use of these 
poisons. If the child frets and does not 
sleep, it is either hungry or ill; if ill, it needs 
a physician. Never quiet it by candy or 
cake; they are the common causes of diar 
rhoea, and of other troubles. 

Rule IY. 

Give the child plenty of fresh air. In the 
cool of the morning and evening send it out 



MANAGEMENT OF INFANTS. 51 

to the shacly sides of broad streets, to the 
public squares, or to the park ; make frequent 
excursions on the river. Whenever it seems 
to suffer from the heat, let it drink freely of 
water, or ice-water. Keep it out of the room 
in which washing or cooking is going on. It 
is excessive heat that destroj~s the lives of 
young infants. 

Rule V. 

Keep your house sweet and clean, cool, 
and well aired. In very hot weather let the 
windows be open day and night. Do your 
cooking in the yard, in a shed, in the garret, 
or in an upper room. Whitewash the walls 
every spring, and see that the cellar is clear 
of all rubbish. Let no slops collect to poison 
the air. Correct all foul smells by pouring 
carbolic acid or quicklime into the sinks or 
privies. The former article can be got from 
the nearest druggist, who will give the need- 
ful directions for its use. Make every effort 
yourself, and urge your neighbors to keep 
the gutters of your street or court clean. 



52 MANAGEMENT OF INFANTS. 



Rule VI. 

Breast-milk is the only proper food for in- 
fants. If the supply is ample and the child 
thrives upon it, no other kind of food should 
be given while the hot weather lasts. If the 
mother has not enough, she must not wean 
the child, but give it besides the breast 
goat's or cow's milk, as prepared under Rule 
VIII. Nurse the child once in two or three 
hours during the day, and as seldom as pos- 
sible during the night. Alwa}^ remove the 
child from the breast as soon as it has fallen 
asleep. Avoid giving the breast when } x ou 
are overfatigued or overheated. 

Rule VII. 

If, unfortunately, the child must be brought 
up by hand, it should be fed on a milk diet 
alone, and that warm milk out of a nursing- 
bottle as directed under Rule VIII. Goat's 
milk is best, and next to it cow's milk. If 
the child thrives upon this diet, no other 
kind of food whatever should be given while 



MANAGEMENT OF INFANTS. 53 

the hot weather lasts. At all seasons of the 
3'ear, but especially in summer, there is no 
safe substitute for milk to an infant that has 
not cut its front teeth. 

Sago, arrowroot, potatoes, corn-flour, 
crackers, bread, eveiy patented food, and 
every article of diet containing starch can- 
not and must not be depended upon as food 
for very young infants. Creeping or walk- 
ing children must not be allowed to pick up 
unwholesome food. 

Rule VIII. 
Each bottleful of milk should be sweetened 
Iry a small lump of loaf sugar, or by half a 
teaspoonful of crushed sugar. If the milk is 
known to be pure, it may have one-third part 
of hot water added to it ; but, if it is not 
known to be pure, no water need be added. 
When the heat of the weather is great the 
milk may be given quite cold. Be sure that 
the milk is unskimmed ; have it as fresh as 
possible, and brought very early in the morn- 
ing. Before using the pans into which it is 
to be poured, alwa} r s scald them with boiling 



54 MANAGEMENT OF INFANTS. 

suds. In very hot weather boil the milk as 
soon as it comes, and at once put away the 
vessels holding it in the coolest place in the 
house, upon ice, if it can be afforded, or down 
a well. Milk carelessly allowed to stand in 
a warm room soon spoils, and becomes unfit 
for food. 

Rule IX. 

If the milk should disagree, a tablespoon- 
ful of lime-water may be added to each bot- 
tleful. Whenever pure milk cannot be got, 
try the condensed milk, which often answers 
admirably. It is sold by all the leading 
druggists and grocers, and may be prepared 
b}^ adding, without sugar, one teaspoonful 
or more, according to the age of the child, 
to six tablespoonfuls of boiling water. Should 
this disagree, a teaspoonful of arrowroot, of 
sago, or of corn starch, to the pint of milk 
may be cautiously tried. If milk in any 
shape cannot be digested, try for a few days 
pure cream diluted with three-fourths or 
three-fifths of water, returning to the milk as 
soon as possible. 



MANAGEMENT OF INFANTS. 55 

Rule X. 

The nursing-bottle must be kept perfectly 
clean, otherwise the milk will turn sour, and 
the child will be made ill. After each meal 
it should be emptied, rinsed, and taken apart, 
and the tube, cork, nipple, and bottle be 
placed in clean water, or in water to which a 
little soda has been added. It is a good plan 
to have two nursing-bottles, and to use them 
by turns. 

Rule XI. 

Do not wean the child just before or during 
the hot weather, nor, as a rule, until after its 
second summer. If suckling disagrees with 
the mother she must not wean the child, but 
feed it in part out of a nursing-bottle on 
such food as has been directed. However 
small the supply of breast-milk, provided it 
agrees with the child, the mother should 
carefully keep it up against sickness ; it alone 
will often save the life of a child when every- 
thing else fails. When the child is over six 
months old the mother may save her strength 



56 MANAGEMENT OF INFANTS. 

by giving it one or two meals a day of stale 
bread and milk, which should be pressed 
through a sieve, and put into a nursing-bot- 
tle. When from eight months to a } T ear old, 
it may have also one meal a day of the yolk 
of a fresh and rare boiled egg^ or one of beef 
or mutton broth, into which stale bread has 
been crumbled. When older than this it can 
have a little meat finely minced, but even 
then milk should be its principal food, and 
not such food as grown-up people eat. 



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